急性脑梗死(6h)的尿激酶、降纤酶与常规治疗的临床对照研究

Clinical Contrast Study on Urokinase,Defibras and Normal Treatment on Acute Cerebroal Ischemic

目的评价急性脑梗死（ACI）发病后6 h尿激酶溶栓与降纤酶治疗的临床疗效.方法将96例ACI患者随机分成3组,尿激酶组、降纤酶组、对照组各32例.尿激酶组予尿激醇（UK）100～150万U溶于0.9%氯化钠溶液150 ml 30min静滴.降纤酶组予降纤酶10 U加入0.9%氯化钠溶液150 ml静滴,对照组采取..常规方案治疗.评价治疗前和治疗后2 h、1 d、7 d、14 d的神经功能缺损评分及3个月、6个月随访Barthel指数评分,并比较其安全性.结果治疗后2 h、1 d、7 d、14 d时神经功能缺损评分UK组较降纤酶组、对照组改善显著,降纤酶组7 d、14 d时较对照组改善显著.3个月、6个月随访Barthel指数评分,尿激酶组、降纤酶组及对照组疗效间差异均有显著性意义.3组间安全性比较差异无显著性意义.结论早期ACI UK溶栓治疗起效快、作用强、效果好.降纤酶治疗也有一定疗效.只要严格掌握适应证及药物用量,两种治疗均安全可靠.

Objective To analyze the clinical effect on Urokinase and Defibrase in treating acute ischemic cerebrovascular disease （ACI） in 6 h. Methods 96 ACI cases in 6h were divided in three groups ： UK group. Defibrase group and control group. UK group were treated with UK 100 - 150 × 104 U in InjNS150 ml （ ivgtt in 30minutes）. Defibrasegroup were treated with 10 U in InjNS150 ml （ ivgtt in 60minutes）. Control group were treated with ordinary method. All patients were assessed with the handicap of neural function before treating and 2 h 1, 7, 14 days after treating. And the security was evaluated. Results The handicap of neural function of UK group were significantly higher than defibrase group and control group 2 h, 1, 7, 14 days after treating. The handicap of neural function of defibrase group were significantly higher than control group. The Barthel Index of UK groups was higher than defibrase group and control group, and the Barthel Index of defibrase group was higher than control group 7, 14 days after treatment. There was no significant difference among three groups in bleeding side effect. Conclusion Therapy of UK adopted soon after the onset of AIC is a safe, effective method. Defibrase shows effective too. Both remedies were safe under strict control in drug dosage and adaptable symptom.